For Employers

Innovatus Health Employer Solutions

In this competitive market with the increasingly rising cost of providing health benefits to employees; and understanding that health benefits are vital for employers to recruit and retain their most valued assets, Innovatus Health was formed to give employers options through self-funded plans. We offer a tiered approach to partnering with us to drive value, including the following services:

  • Care Management Only
  • Care Management, Custom Plan Design, Medical Economics to understand the highest quality in our network
  • Care Management, Medical Economics, PBM, and Full TPA Services

  1. Care Management Programs with 'on the ground' nursing, pharmacy, and social work support, tied into primary care and the overall care plan for a patient, with Wellness weaved into all the programs.
  2. High Performing Network. Backed by robust Medical Economics analysis, we've assembled a comprehensive network serving the seven-county region focusing on strong physician alignment and care coordination, to drive quality and appropriate cost.
  3. National Wrap Network. Our relationship with one of the largest national network brings the right level of coverage for specialty care when not available in our region.
  4. Custom plan design. We can mirror and improve your existing plan, our work with you to create a new solution, leveraging our PBM relationship, built on value based care as well as our TPA services, if you desire the move from your legacy service.

Executive Summary

Learn what makes Innovatus the solution you are looking for.

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Innovatus Health Plans are designed for companies with as little as 50 employees with the following key features:

  • One monthly bill includes fixed claims costs
  • Competitive rates versus fully insured products
  • Advanced PBM Programs
  • Access to monthly claims reporting, analytical data, predictive modeling, and benchmarking
  • Better management of your high-dollar claimants via effective cost-containment programs
  • ERISA-qualified, so you can tailor your benefits and avoid some of the Affordable Care Act-associated fees and taxes

Why Self-Fund:

Self-Funding takes away the keys from the large payers and put all the controls in the hands of the employer:

  • Allow flexibility in value-added programs: Self-funded programs have choices in network partners, utilization management, large case management, and other programs for a full complement of plan-appropriate partners.
  • Lower fixed costs: Administrative fees of Innovatus Health are lower than those of large insurance companies.
  • Improve cash flow: Self-funding allows you to retain funds until needed, which can create additional revenue for the you in a tightly run business.
  • Flexible plan design: Allows you to customize how you wish to deliver benefits to address the changing needs of the business and its employees.

Benefit Design

Innovatus Health offers a range of plans and product choices. The varieties of plans are designed to meet the needs of different employer groups of all sizes. Choose among our Platinum, Gold, Silver or Bronze plans with features such as: lower premiums, varying copayment/ co-insurance amounts, and deductibles with the following core services:

  • Utilization Management provides medical necessity reviews for services as directed by the plan sponsor.
  • Case Management helps patients who experienced a serious health event navigate the health care system to ensure appropriate care
  • Disease Management offers support and education for participants with chronic health issues or whose lifestyles put them at risk of serious illness.
  • Health and Wellness provide engaging services to participants to improve their health.

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